Shots - Health Blog

10:45 am

Tue March 6, 2012

Before Leaving The Hospital, Consult Your Checklist

When checking into a hospital, patients naturally worry whether their visit will go well. But leaving the hospital safely can sometimes present an even trickier challenge.

Patients are going home sooner and sicker than ever before. And without clear and comprehensive instructions about what to do after a hospital stay, they may wind up back in the hospital, or worse.

A recently published book, The Patient's Checklist, aims to guide patients safely through every stage in a hospital stay, starting before you arrive and continuing on through that crucial transition phase in care when you leave the hospital for home or rehab.

Author Elizabeth Bailey, a former music video producer, came up with the idea for a book of checklists while caring for her ailing father at a New York City hospital.

Checklists had been an essential tool to keep herself organized during video shoots. And doctors have been using checklists for years to improve patient safety.

Bailey hoped they could do the same at the hospital, where the cast of caregivers changed constantly, mistakes were routine and no one seemed to have a comprehensive care plan for her dad.

Discharge instructions played a major role in Bailey's father's problems. Initially admitted for an outpatient biopsy to determine if he had an inflammation of the artery near his temple called temporal arteritis, his vague post-op instructions said to "continue all pre-op medications."

Not realizing that referred only to routine medications he took before surgery, Bailey's father continued to take a strong steroid he had been prescribed prior to the surgery, and even refilled the prescription.

Within days he wound up in the emergency room with steroid-induced psychosis. He didn't leave the hospital for almost a month.

The book's discharge plan checklist contains, among other things, specifics to quiz healthcare personnel on such as:

What physical or emotional symptoms might you experience that are normal reactions in response to your treatment or illness?

What red flag events or side effects would be cause for alarm?

How should you care for the surgical site or drains and IVs, including how to bathe and how to identify signs of infection?

What's the plan for managing pain, and what should you do if your pain is getting away from you?

"It's not brain surgery to learn to become more involved in your care," says Bailey. "The book gives an idea for a framework and helps with how to ask questions."